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academies
Microbiology: Current Research
Volume 2
International Conference on
Emerging Diseases, Outbreaks & Case Studies
&
16
th
Annual Meeting on
March 28-29, 2018 | Orlando, USA
Influenza
Background:
Many cases of Middle East Respiratory
Syndrome Coronavirus (MERS-CoV) have been identified
in the Kingdom of Saudi Arabia (KSA) since 2012. As of
early December 2015, 549 of 1,277 patients (43%) with
laboratory-confirmed MERS-CoV whom treated in Ministry
of Health hospitals in KSA, confirmed to have died. Two
main pathways by which MERS-CoV were reported to be
transmitted: animal-to-human (AH) (primary infection); and
human-to-human (HH) (secondary infection), most human
cases reported to date have resulted from human-to-human
transmission in health care settings. Although our knowledge
of the clinical features of MERS-CoV infection has grown over
the past three years, however, the pathogenesis of disease
and treatment outcomes are still not well known. We aim in
this study to investigate the differences between MERS-CoV
animal-to-human and human-to-human transmitted cases,
in relation to virulence and response to treatment.
Methods:
All cases of laboratory-confirmed MERS-CoV
occurring at King Fahad Hofuf Hospital in Al-Ahsa, Saudi
Arabia, from April 1, 2012 to November 30, 2016 were
reviewed retrospectively. Virulence (symptoms/severity
of disease) was identified by using Acute Physiology and
Chronic Health Evaluation II (APACHE II) and Sequential
Organ Failure Assessment (SOFA) scoring systems, mode
of MERS-CoV transmission, patients’ demography, baseline
characteristics, X-ray and laboratory findings, co-morbidities,
prognosis and treatments’ outcomes were identified.
Results:
From April 1, 2012 to November 30, 2016, there
were 107 laboratory-confirmedMERS-CoV cases, of which 23
(21.4%) cases were transmitted fromAH and 84 (78.6%) were
transmitted from HH mode. Ten (43%) AH and 43 HH MERS-
CoV Patients’ groups were admitted to ICU, time from onset
of symptoms to ICU admission was (8 days (3-14) median
AH group and 4 days (3-11) median for HH group. APACHE
II score was higher in (AH, 11.2) group than (HH, 23) group
P value 0.043. In AH group, n=2 patients were recovered,
(n=2 transferred) to another care center, (n=9 died) and (n=4
discharged), whereas in HH group (n=5 recovered), (n=22
transferred), (n=45 died) and (n=12 discharged). Time from
onset of MERS-CoV symptoms to death was (11 days, (8-17)
median) for AH group and (5 days (6-9) median) HH group,
P value 0.043. Piperacillin, tazobactam and levofloxacin
was the most common combination prescribed to treat
pneumonia in AH MERS CoV group (n=9, 39%), and (n=15,
18%) for HH group, whereas ribavirin was the most common
used antiviral drug in AH (n=8m 35% for 11 days) and HH
(n=53, 63% for 18 days) MERS-CoV groups.
Conclusion:
Despite the small sample size of our study,
higher APACHE II score was observed in human-human
MERs CoV transmitted group in compare to animal to human
group, accompanied with poor prognosis witnessed by short
time from appearance of symptoms and transferring to ICU
and death.
Speaker Biography
Mansour Tobaiqy is an Assistant Professor of Clinical Pharmacology in the Faculty of
Medicine, University of Jeddah, KSA. He is also the General Supervisor of the Human
Resources Development Centre in the same university and he has completed his PhD in
Medicine and Therapeutics from the School of Medicine, University of Aberdeen, UK.
He is also a Visiting Professor at RGU, UK. He has done several researches on the safety
medicines in children and pharmacovigilance in general
e:
mtabaki@uj.edu.saApparent poor prognosis for patients infected with MERS-CoV through human-human mode than
animal-human
Mansour Tobaiqy
1
, Saad Alhumaid
2
, Mohamoud Albagshi
2
, Ahmed Alrubaya
2
, Fahad Algharib
2
, Ahmed Aldera
3
and
Jalal Alali
2
1
University of Jeddah, Saudi Arabia
2
King Fahad Hofuf Hospital, Saudi Arabia
3
Prince Saud Bin Jalawi Hospital, Saudi Arabia